Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Nov 2013
Randomized Controlled TrialEffects of adrenaline on rhythm transitions in out-of-hospital cardiac arrest.
We wanted to study the effects of intravenous (i.v.) adrenaline (epinephrine) on rhythm transitions during cardiac arrest with initial or secondary ventricular fibrillation/tachycardia (VF/VT). ⋯ Patients who received adrenaline had more rhythm transitions from ROSC and non-shockable rhythms to VF/VT.
-
Clinical guidelines on central venous catheterisation were introduced by the Swedish Society of Anaesthesiology and Intensive Care Medicine in 2011. The purpose of this study was to investigate current national practice and assess to what extent these guidelines influence clinical routines in Swedish operating wards and intensive care units. ⋯ Knowledge of the Swedish guidelines was adequate, and most participating departments had local catheterisation routines. We could identify some variation in practice, but overall adherence to the guidelines was good. Nevertheless, monitoring of procedures and complications of cannulation and maintenance could be in need of improvement.
-
The World Health Organisation estimates that traumatic injuries are among the leading global causes of death. Studies have shown that a formalised and structured organisation of trauma care, termed trauma systems, have reduced mortality after injury. The centralisation of management to specialised trauma hospitals for the most severely injured patients is a key component of trauma systems. ⋯ The quarter of the population living in the most rural municipalities had 33% higher risk of dying from an injury compared with the remaining population. More patients also died before reaching hospital in rural areas. To ensure both quality and equality in a Norwegian trauma system, improving access to centralised care for rural populations is a challenge that must be prioritised.
-
Acta Anaesthesiol Scand · Nov 2013
Evolution of anaesthesia care and related events between 1996 and 2010 in Switzerland.
Anaesthesia Databank Switzerland (ADS) is a voluntary data registry introduced in 1996. Its ultimate goal is to promote quality in anaesthesiology. ⋯ Routine ADS data collection contributes to the monitoring of trends in anaesthesia care in Switzerland. The ADS system has proved to be usable in daily practice, although this remains a constant challenge that is highly dependent on local quality management and quality culture. Nevertheless, success in developing routine regular feedback to users to initiate discussions about anaesthetic events would most likely help strengthen departmental culture regarding safety and quality of care.
-
Acta Anaesthesiol Scand · Nov 2013
Perioperative anaesthetic practice for head and neck free tissue transfer - a UK national survey.
Anaesthetic management of microvascular head and neck free flap surgery is based on physiological principles, but data on how these affect clinical outcomes in this challenging group are limited. There are no evidence-based guidelines available in this area. ⋯ Currently in the UK, anaesthetic perioperative management for head and neck free flap transfer is varied, reflecting the paucity of high-quality data in this area; but some techniques, in particular avoidance of excessive crystalloid use, is associated with improved flap outcome.